April 4-6, 2024 • Hyatt Regency • Lexington, KY
Innovations in Health Communication
Innovations in Health Communication
Abstract: “I can trust her to watch out for me”: Testing the Theory of Motivated Information Management for Persons With Type 1 Diabetes
Diabetes, the eighth leading cause of death in the United States, is the primary cause of kidney disease, blindness, and non-traumatic amputation (CDC, 2023). Individuals with Type 1 diabetes (PWD) navigate a life filled with uncertainties related to their disease management. The theory of motivated information management (TMIM; Afifi & Weiner, 2004) posits that emotional responses arise from discrepancies between desired and actual uncertainty levels, prompting individuals to assess their efficacy and expectations for knowledge gain through interpersonal interaction. Previous TMIM work framed uncertainty as a lack of the seeker’s issue knowledge (Hovick, 2014), but in the context of Type 1 diabetes, uncertainty may hinge on both the seeker’s and the other person's knowledge. These types of uncertainty may distinctly influence feelings about one’s own ability to communication about diabetes (communication efficacy) versus the other person’s ability to do so (target efficacy) as predictors of information management (meta-analysis, Kuang & Wilson, 2021). This study examines how uncertainty about another's knowledge, rather than just one's own, affects efficacy and informs information management in PWD. We contend that PWD survival is directly related to managing not only their own uncertainty, but also the uncertainties of their close others, and that TMIM provides an ideal theoretical context to study these relationships.
To test our hypotheses we used a mixed methods approach. Specifically, we recruited adults with Type 1 diabetes (N=129) from clinical and non-clinical sites to complete an online questionnaire about a meaningful conversation they had about their diabetes with a person they had a close relationship with. Participants were mostly white, college educated, female, middle aged, and married/partnered. We used deductive coding to measure uncertainty discrepancy (self), emotion, communication efficacy and target efficacy. We also had closed-ended items to gauge uncertainty discrepancy (other), message quality (self and other), and willingness to communicate about diabetes. Message quality of a prior conversation was used as a proxy for outcome expectancies, as the perceived effectiveness of prior conversations on the topic will affect the willingness to engage in future conversations with the close other. Our data analysis for this project is ongoing, but preliminary results provide partial support for our hypotheses and indicate differing effects on information management of PWD depending on the type of uncertainty and efficacy at hand (Tables 2 and 3). Step-wise regressions show that it is PWD's perceived uncertainty discrepancy about his/her interactant and that interactant's efficacy that predicts PWD’s willingness to communicate about their diabetes management, as opposed to PWDs' uncertainty discrepancy solely related to themselves, their own efficacy, uncertainty about their disease, or their health status. We plan to conduct structural equation modeling to further assess these relationships.
TMIM research is typically conducted using close-ended self-report items. By using qualitative, open-ended responses, we can provide insight into the types of uncertainty PWD grapple with and how they relate to discussion about diabetes care. Practically, this work can inform health care providers how to better prepare friends and families to enact their critical roles in diabetes management.
To test our hypotheses we used a mixed methods approach. Specifically, we recruited adults with Type 1 diabetes (N=129) from clinical and non-clinical sites to complete an online questionnaire about a meaningful conversation they had about their diabetes with a person they had a close relationship with. Participants were mostly white, college educated, female, middle aged, and married/partnered. We used deductive coding to measure uncertainty discrepancy (self), emotion, communication efficacy and target efficacy. We also had closed-ended items to gauge uncertainty discrepancy (other), message quality (self and other), and willingness to communicate about diabetes. Message quality of a prior conversation was used as a proxy for outcome expectancies, as the perceived effectiveness of prior conversations on the topic will affect the willingness to engage in future conversations with the close other. Our data analysis for this project is ongoing, but preliminary results provide partial support for our hypotheses and indicate differing effects on information management of PWD depending on the type of uncertainty and efficacy at hand (Tables 2 and 3). Step-wise regressions show that it is PWD's perceived uncertainty discrepancy about his/her interactant and that interactant's efficacy that predicts PWD’s willingness to communicate about their diabetes management, as opposed to PWDs' uncertainty discrepancy solely related to themselves, their own efficacy, uncertainty about their disease, or their health status. We plan to conduct structural equation modeling to further assess these relationships.
TMIM research is typically conducted using close-ended self-report items. By using qualitative, open-ended responses, we can provide insight into the types of uncertainty PWD grapple with and how they relate to discussion about diabetes care. Practically, this work can inform health care providers how to better prepare friends and families to enact their critical roles in diabetes management.